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ABCs of IDA—Human Development

For more than 50 years, the International Development Association, IDA, the World Bank’s fund for the poorest, has taken on the most difficult and complex challenges. It has provided support for health, education, infrastructure, agriculture, and economic and institutional development to the world’s 77 poorest countries. IDA works to build resilience to manage shocks and risks, while improving livelihoods and promoting equity and inclusion. (Download ABCs of IDA - Human Development in pdf format.)

With IDA’s help, hundreds of millions of people have escaped poverty—through the creation of jobs, access to schools, health facilities, social safety nets, roads, electricity, and more. On the Human Development front, IDA funding over the past five years has helped immunize 205 million children, provide access to better water sources for 50 million, train or recruit 5.1 million teachers and provide access to health services for 413 million people.

IDA is supporting countries as they work towards universal coverage of basic services and stronger national systems for health, education, and social protection, focusing on priorities including demographic transitions, investing in the early years of life, jobs; and addressing humanitarian crises and the needs of displaced populations.

IDA’s strong, results-focused investments in people are helping to demonstrate the role of human development in underpinning national and household prosperity. Leveraging these investments more extensively—drawing in more resources, particularly from domestic budgets in developing countries and the private sector—is critical as countries seek to end extreme poverty by 2030 and achieve the Sustainable Development Goals.

IDA is replenished every three years with contributions from developed and developing country donors, as well as from two other agencies of the World Bank Group: the International Bank for Reconstruction and Development and the International Finance Corporation. Learn more about what IDA has achieved in Human Development in the results highlighted below.

Between 2006 and 2015, there was a threefold increase in births attended by skilled birth attendants from 19 percent to 57.5 percent. During the same period, the percentage of pregnant women with at least one ante-natal care visit increased from 32.3 to 59.6 percent, while the percentage of children aged 12-23 months, with all recommended vaccinations, increased from 27.1 to 57.7 percent. This has contributed to a 30 percent reduction in stunting rates and an infant mortality rate of 45 deaths per thousand births, which is now one of the lowest in the region.

Angola

By 2014, 167,809 children were immunized, up from 34,000 in 2012. During the same period, 71 percent of children aged 0-1 were immunized with the pentavalent vaccine, up from 27 percent.

From 2013 to 2014, 2.3 million people accessed a basic package of health, nutrition, or reproductive health services.

Bangladesh

Between 2011 and 2015, 61 percent of beneficiaries of a rural livelihood program increased their incomes by 50 percent. Over the same time period, 48,780 jobs were created for young people.

A Results-Based Financing project has raised secondary school enrollment among the poorest children by 27% and the secondary pass rate has risen from 55% in 2008 to 85% in 2014 in the project areas.

From 2009 to 2014, university enrollment more than doubled from 387,000 to 853,000 students. 337 departments and institutes received block grants for overhauling facilities for teaching and research, directly benefiting 118,000 students and teachers.

From 2011 to 2015, 116,200 polytechnic students from low-income families have received financial support to cover educational expenses. Enrollment in polytechnics doubled from 84,000 in 2010 to 170,000 in 2014.

Benin

Districts covered by a Results-Based Financing project in Benin achieved an 86 percent immunization rate as of 2015. The country-wide immunization rate is 40 percent.

Bosnia and Herzegovina

From 2010 to 2015, 11,400 people benefited from employment services and targeted cash transfers. 55 percent of people who received training and an employment subsidy remained employed for a year after the training or subsidy ended.

Burkina Faso

Contraceptive prevalence has increased from 15 to 22 percent, and assisted deliveries from 67 to 82percent between 2010 and 2013.

Cambodia

In 2014, 85 percent of births were attended by a trained health professional, up from 58 percent in 2008. Also, 98 percent of children under one year old received immunizations against diphtheria, pertussis, tetanus and hepatitis B in 2014, up from 84 percent in 2008.

Between 2006 and 2015, grade 3 students’ achievement in reading and math increased by about a year’s worth of learning. These large and significant differences are system-wide and national in scale.

Cameroon

From 2012 to 2013, 428,925 people had better access to health facilities, 44,340 students received better access to school facilities, and 427,100 residents had access to an improved water source.

3.3 million people received access to a basic package of health, nutrition or reproductive health services from 2009 to 2015. Over the same time period, 197,333 children were immunized and 197,333 births were attended by a skilled professional.

Central African Republic

327,843 people received access to a basic package of health, nutrition or reproductive health services from 2012 to 2015.

119,000 people were tested for HIV from 2000 to 2012, including more than 10,000 pregnant women, 2,000 teachers, and nearly 7,000 military personnel and their families.

1,023 teachers and 22 heads of school were recruited and trained; 3,000 new curricula were printed; and 178,500 textbooks, 5,596 school kits, and 5,130 table benches were distributed between 2007 and 2012.

Chad

2.6 million books were distributed to schools, 400 classrooms were built and equipped, 20,000 people were taught to read and write, and 11,700 community teachers were trained from 2003 to 2012.

Comoros

More than 71,000 people have benefited directly from cash-for-work and community-based infrastructure projects with IDA emergency financing in response to the global crises and the local floods of 2012.

Côte d'Ivoire

44 percent of HIV-infected pregnant women were receiving antiretroviral treatment in 2012 to reduce the risk of mother-to-child transmission, up from 0 in 2007.

IDA emergency financing in Côte d’Ivoire has employed over 12,600 youth in labor-intensive public works, and provided over 6,800 youth with entrepreneurship training and over 4,300 with apprenticeship contracts.

An awareness campaign on HIV /AIDS, civics and citizenship, and environment and public hygiene reached over 11,800 youth under the same project.

Djibouti

From 2012 to March 2016, 12,170 pregnant or lactating women, adolescent girls and children under age 5 received basic nutrition services, including provision of micronutrient powders and supplements and growth monitoring for children under two. More than 4,800 households also participated in a public works program that created 364,950 days of employment.

From 2013 to 2015, 374,272 people benefited from a project to improve the quality of health care. 24,113 pregnant and lactating women, adolescent girls and children under age 5 received basic nutrition services from 2014 to 2015. Over the same time period, 4,139 women gave birth assisted by qualified personnel.

Ethiopia

Poverty fell from 44 percent in 2000 to 29.6 percent in 2011—driven by IDA-supported agricultural growth projects, government spending on basic services, and effective safety nets, underpinned by consistent and high economic growth.

58.5 percent of pregnant women received at least one prenatal care visit in 2014, up from 43 percent in 2012 and deliveries attended by skilled birth providers increased by more than 50 percent during the same period.

78.1 million textbooks and teachers’ guides were developed, printed and distributed to primary and secondary schools in Ethiopia, and more than 148 new textbook titles and teacher guides were developed in five languages from 2010 to 2013 under the General Education Quality Improvement Project. During the same time period, 92,541 primary teachers upgraded their qualifications from a one-year certificate level to a three–year diploma level in accordance with newly-adopted regulations.

Ghana

5.9 million days of employment were provided to a total of 123,106 unskilled workers, with women making up about 60 percent of the beneficiaries, from 2010 to 2015.

Under the Ghana Secondary Education Improvement project, 2143 students from low-income households received scholarships to be able to attend secondary school and 576 teachers received training to upgrade or acquire new skills in science.

Guyana

From 2011 to 2015, more than 700 new teachers were trained for nursery, primary and secondary classrooms. Through a year-long induction program, the new teachers received the guidance and support of more experienced ones, thereby enhancing the learning potential of 1200 Guyanese schoolchildren, of which 84 percent were female.

Haiti

Testing and treatment was provided for 9,776 people hospitalized for cholera in 98 communes from October 2014 to September 2015. 19,320 household visits were conducted as part of awareness raising campaigns and 19,800 houses and 3,515 latrines were decontaminated over the same time period.

From 2012 to 2016, 437,905 tuition waivers were financed, allowing disadvantaged children to attend primary school.

During the 2015-2016 school year, over 132,200 students received daily meals across 430 schools; and 7,200 children in poor rural and previously underserved Haitian communities were able to attend school and receive school kits including learning materials (pens, pencils, notebooks and a backpack) and over 40,000 primary textbooks.

From 2012 to 2015, the massive nationwide Sarva Shiksha Abhiyan (SSA) program for elementary education reached more than 120 million children across about 1.4 million schools, helping improve the pupil-teacher ratio from 30 students per teacher to 25. During that same period, teacher attendance improved from 75 percent to 85 percent, while the share of professionally trained teachers remained stable, thereby establishing the foundation for improved quality of education. In addition, the ratio of girls to boys enrolled in government schools improved from 1:1 in 2012 to 1:1.03 in 2015.

IDA also supports India’s national secondary school program, the Rashtriya Madhyamik Shiksha Abhiyan (RMSA). The program has helped achieve gender parity in secondary school. In 2009/10 there were 88 girls in secondary school for every 100 boys. By 2014/15 there were more girls than boys.

IDA is a key external financier of a remarkable AIDS response in India. It financed the fourth National AIDS Control Project which has seen number of adult new infections decline by 30% (from 106,335 in 2007 to 75,984 in 2015) nationally, and by 50% (from 36,402 in 2007 to 18,430 in 2015) in the high prevalence states of Andhra Pradesh, Karnataka, Tamil Nadu, Maharashtra, Manipur and Nagaland.1 Thanks to targeted prevention interventions, an estimated 3 million HIV infections will have been averted by the end of 2015.

A project to improve the quality of technical education sharply raised students’ employment rate from 41 percent to 76 percent.

Kenya

As of 2015, 2.6 million individuals are benefiting from cash transfer support through the National Safety Net Program, up from about 1.7 million in 2013.

A multi-sectoral youth empowerment project combined classroom and on-the-job training in partnership with employers for over 13,300 young people.

In response to a crippling humanitarian crisis in the Horn of Africa resulting from a severe drought and the outpouring of Somali refugees, IDA supported food security and health in the world’s two largest refugee camps, Dadaab in Kenya and Dollo Ado in Ethiopia. IDA contributed US $30 million from 2011 to 2013, to support the United Nations High Commissioner for Refugees’ (UNHCR) delivery of emergency services, benefiting more than 1.6 million individuals. Nearly 86,000 children with severe acute malnutrition were treated, far exceeding the target of 5,275, and more than 174,000 pregnant and lactating women received food supplements, exceeding the target of 23,475.

1,500 school directors received leadership training to enhance school based management and instructional leadership;

3,000,000 copies of textbooks, teacher guides, and student workbooks were printed and distributed; and

Access to preschool increased from 18 to 50 percent, enrolling 55,000 children out of 80,000 aged 5-6 in school preparation program to ensure smooth transition to primary schooling through IDA leveraged trust fund.

Between 2012 and 2015, 550,577 children under 12 months were immunized against DTP3. In 2015, 15,568 health personnel attended professional development courses, up from 14,008 in 2012.

Lesotho

100 NGOs received training from 2013 to 2015 in two of five priority areas related to addressing the HIV epidemic in Lesotho.

Liberia

10,800 hours of on-the-job training were provided from 2011 to 2015 through a project to improve and maintain roads.

Madagascar

In 2015, more than 2.9 million students in Madagascar benefited from projects financed by IDA and the Global Partnership for Education.

762,882 people were provided with access to a basic package of health, nutrition or reproductive health services from 2012 to 2014.

149,376 children were immunized between 2012 and 2015 and 74,593 births were attended by skilled health personnel between 2012 and 2014.

Mali

As of end September 2015, 43,613 households, representing 349,031 people, were benefiting from cash transfers and accompanying measures. More than half of the beneficiaries were women and children.

Mauritania

In just over a year starting in May 2014, Mauritania completed contracts for 13 planned secondary schools to attract girls to lower secondary education; provided training for nearly 8,800 primary school teachers; printed and distributed 322,000 school kits to students in grades 4 and 5; and began development and printing of more than 1 million textbooks for basic education.

Moldova

Application processing for Moldova’s social assistance program fell from 30 days in 2010 to 8.4 days in 2015 thanks to an online management information system.

Mongolia

From 2007 to 2013, 3,560 classroom libraries were established in all 383 primary schools, in rural Mongolia. Each school received over 160 books, benefiting a total of 130,000 students. 4,144 rural primary teachers and 383 school directors were trained. A local professional development network was set up, consisting of 95 core schools and 178 mentor teachers.

The combination of teachers training together with students receiving books helped increase students’ test scores.

Mozambique

In rural areas, 84,000 young children are benefiting from community-based preschool programs that focus on cognitive, linguistic, socio-emotional and physical skills aimed at increasing chances of success in primary school and beyond.

81.5 percent of 6 year olds were enrolled in first grade in 2015, up from 70 percent in 2011. From 2011 to 2015, project interventions led to the addition of 14,722 qualified primary school teachers.

1.9 million insecticide-treated malaria nets were purchased and distributed in Mozambique from 2010 to 2014.

Myanmar

From 2013 to 2015, 850,000 people in 1,729 villages benefited from 1,800 basic infrastructure and services projects, including projects to improve school facilities and village access roads.

37,000 students received cash payments in the 2014-15 school year to prevent at-risk students from dropping out.

Nepal

In 2015, 6 million women received prenatal care during a visit to a health provider, up from 2.6 million in 2010. 1.3 million children had been immunized in 2015, up from 580,000 in 2010.

55.6 percent of births in 2015 were attended by a skilled professional in 2015, up from 28.8 percent in 2009.

77.6 percent of students completed primary education (grades 1-5) in Nepal in 2014, up from 58 percent in 2009.

As of August 2015, more than 73 percent of graduates of vocational training programs were gainfully employed for at least six months after the training program, compared to 68 percent in March 2014.

Nicaragua

An IDA-supported education project in Nicaragua increased the retention rate for primary school students within the school year from 87 percent in 2012 to 89 percent in 2013. The project also provided 1.3 million textbooks, 92,600 of which were published in native languages of the Caribbean coast, and trained 1,541 teachers from 2012 to 2015.

From 2012 to 2015, around 225,000 primary students in the poorest regions of the country, representing 25% of the national enrollment in primary education, received 1.4 million primary textbooks. In addition all primary students of afro descent and indigenous populations received textbooks in their native languages for the first time ever.

During the same period, approximately 200,000 primary students received school kits including learning materials (pens, pencil, and folders), school clothes (shoes) and a backpack.

In rural areas, 1,156 primary schools, received new school furniture (desks, white boards and cabinets) and 1,433 new primary teachers received pre-service training under an innovative program for multi-grade education. As of today, more than 90% of them are now teaching in their community of origin.

Between 2010 and 2016, an IDA-supported health project had 156 agreements between the Ministry of Health and municipalities to strengthen quality local health networks based on results-based financing. It has focused on adolescent pregnancy prevention, trained 8,933 adolescent leaders and created 1,415 adolescent health circles for awareness and support, and trained 8,549 teachers from grades 5 to 12 on adolescent reproductive health. It has also funded 8,414 radio messages and 1,405 television spots and equipped 66 health municipal networks and 12 hospitals.

Niger

Between 2011 and 2015, 1.8 million days of temporary employment were created, of which 477,630 days were for women.

44,888 households received access to cash transfers from 2011 to 2015.

Nigeria

55.5 million children were immunized against polio in Nigeria in 2015.

Zero cases of wild polio were observed from July 2014 to July 2015, which is an important milestone on the country’s path to being polio-free.

63,350 pregnant women living with HIV received a complete course of antiretroviral prophylaxis to reduce the risk of mother-to-child transmission in 2015, an increase of 87 percent since 2010.

The Nigeria Youth Employment and Social Support Operation has used community-based targeting and compilation to set up a single registry system across eight states, with about 30,000 households and 150,000 individuals registered.

Under the Nigeria State Education Program Investment Project, which is operational in Anambra, Bauchi, and Ekiti states, there has been a sharp improvement in need-based teacher deployment to rural areas and by core subjects.

Pakistan

More than 20 million of poorest people in Pakistan’s poorest people have benefited from a national social safety net program between 2009 and 2016. During this period, $3.5 billion was provided in cash transfers through debit cards, mobile phones and smart cards. By doubling female access to biometric national identification cards and making payments to female heads of 5.2 million beneficiary families, the program has significantly contributed to women’s empowerment. In addition, more than 1.3 million poorest children have been enrolled in a primary education Conditional Cash Transfer Program, of which nearly 50 percentage girls. The program also established a national social registry containing welfare information on more than 27 million households (approximately 167 million people) to ensure the government is effectively reaching the poorest for service delivery.

Under the Second Sindh Education Reform Project—an IDA-financed Results-Based Financing project in education—16,800 teachers were recruited through a test, merit and need based recruitment process. Quality teachers are essential to raise the low level of learning in schools.

1.2 million households received early recovery cash transfers after 2010 floods in Pakistan which covered 100,000 square kilometers and destroyed roughly 1.6 million homes.

Rwanda

Under the Rwanda Skills Development Project, 70 percent of program graduates are employed, of whom 80 percent found jobs within six months of graduation.

Senegal

86.8 percent of children were enrolled in primary school in 2014, compared with 81.9 percent in 2005; 73.4 percent of students completed primary school in 2014, compared with 53 percent in 2005; and there was a 52 percent increase in university enrollment.

Children aged 0 to 24 months in poor and rural areas who showed adequate monthly weight gain increased from 50% in 2006 to 84% in 2014. The percentage of children who were underweight decreased from 20% in 2000 to 14% in 2012, and stunting decreased from 30% in 2000 to 16% in 2012.

South Sudan

1.2 million long-lasting insecticide-treated malaria nets were purchased and/or distributed in South Sudan in 2014, up from 126,451 in 2012.

374,206 children ages 6 to 59 months received a dose of vitamin A in 2013, a 2,000 percent increase since 2011.

47,287 children under 12 months in South Sudan received the DPT3 vaccination to protect against diphtheria, pertussis and tetanus in 2013, up from 16,986 in 2011.

Sri Lanka

From 2011 to 2015, 3.2 million students and 186,500 teachers have benefited from a project to improve access to quality of primary and secondary education in Sri Lanka.

Tanzania

The Productive Social Safety Net Program is allowing 1.1 million Tanzanian households (over 6 million people) to receive regular conditional cash benefits. The program has effectively reached the poorest 15 percent of the population, including 100 percent of the extreme poor population, including the group of households which are vulnerable to fall below the food poverty line.

16.9 million work-days were provided through public works in 2015, an increase of 213 percent from 5.4 million work-days in 2005.

Under the Big Results Now in Education Program for Results, 33,500 teachers have received 3R training.

Togo

From 2012 to 2015, 3,275 people benefited from the construction of 90 schools with 248 classrooms, 13 health centers, 44 boreholes, four community latrines, two rural roads and crossing structures, and two market sheds.

14,016 people received financial assistance between 2013 and 2015 as part of a social safety net program to combat child malnutrition in Togo.

Uganda

170,900 people accessed a basic package of health, nutrition or reproductive health services in Uganda between 2009 and 2014. During this period, 961 health personnel received training and 230 health facilities were constructed, renovated or equipped.

As part of the East Africa Public Health Laboratory Networking Project, Uganda’s National Tuberculosis Reference Laboratory reached the gold standard ISO accreditation and qualified to serve as a prestigious WHO Supranational Reference Laboratory, the second of its kind on the continent.

Uzbekistan

170,900 people accessed a basic package of health, nutrition or reproductive health services in Uganda between 2009 and 2014. During this period, 961 health personnel received training and 230 health facilities were constructed, renovated or equipped.

As part of the East Africa Public Health Laboratory Networking Project, Uganda’s National Tuberculosis Reference Laboratory reached the gold standard ISO accreditation and qualified to serve as a prestigious WHO Supranational Reference Laboratory, the second of its kind on the continent.

Vietnam

Through two large projects, the health insurance coverage of the near-poor increased from 10% in 2010 to 92 % in 2015 in the Central North region (population 10 million) and from 3.5% in 2013 to 99% in 3.5% North East and Red River Delta region (population 15 million).

Under the Vietnam School Readiness Promotion Project, 84% of preschoolers have enrolled in full day pre-school from a baseline of 74% in 2012.

Yemen2

From 2013 to 2015, 9.6 million people received cash transfers to alleviate a sharp deterioration in living conditions following the Yemen’s 2011 crisis. More than half of the recipients were women.

From 2012 to 2015, 101,042 people accessed improved primary health care services, 121,193 people had access to improved water sources, and 41,039 people had access to improved sanitation facilities.

From 2012 to 2016, two IDA-supported polio immunization campaigns have vaccinated 4.3 million children under 5 years old in 21 governorates in Yemen. The Bank has also supported routine, integrated outreach sessions to provide immunization, mother and child health, and nutrition and disease control services, as well as health education to communities with no access to fixed medical facilities.

In Yemen, through IDA support, 4,270 primary classrooms were constructed and rehabilitated, 50 secondary education schools were equipped with science computer labs and libraries. More than 78,000 primary and secondary teachers were trained, and 1,675 new female teachers were trained, certified and deployed in rural areas.

In addition, more than 61,700 girls in Grade 4-9 benefited from conditional cash transfer, which contributed to improve girls’ enrollment and retention in disadvantaged areas. Girls’ enrollment in basic education increased by 17.5% and the Gender Parity Index (GPI) improved from 0.7 to 0.77 in targeted 10 governorates and the secondary education GPI improved from 0.43 to 0.63 in targeted districts.

On tertiary education, new academic programs responding to labor market needs were successfully implemented in 8 public universities.

Zambia

404 health facilities were constructed, renovated, or equipped and 345 health personnel received malaria screening and treatment training between 2010 and 2013.

2.5 million long-lasting insecticide-treated malaria nets were purchased or distributed between 2010 and 2013.

Regional Initiatives in Africa

The East Africa Public Health Laboratory Networking Project

Since 2010, public health officials in East Africa have successfully mounted joint efforts to control the spread of communicable diseases and expand access to quality diagnostic services for vulnerable groups in cross border areas, serving over 4 million beneficiaries (of which 60 percent are females) through a network of 32 upgraded laboratories in Burundi, Kenya, Rwanda, Tanzania and Uganda.

The Great Lakes Emergency Sexual and Gender-Based Violence and Women’s Health Project

Since October 2014, in the Democratic Republic of Congo, over 3,500 survivors of sexual violence have received holistic services, 3,200 received gynecological services, and 58,000 community members participated in sensitization and advocacy activities to improve awareness and knowledge of sexual and gender based violence.

In Rwanda, 17 One Stop Centers were established in hospitals, in line with the National Strategy to ensure multidisciplinary services and protection of survivors. In addition, members of the Rwandan National Police received training on DNA testing in Germany and the United Kingdom.

In Burundi, 74 health workers have been trained on contraceptive technology and essential obstetrical and neonatal care. Preparation activities to set-up One Stop Centers to support survivors of sexual violence are at an advanced stage.

The regional Africa Centers of Excellence project has enrolled over 2,410 regional students in short-term courses, Masters, and PhD programs at 19 centers of excellence in seven countries. IDA is helping maximize regional efficiencies and develop homegrown talent to solve pressing development challenges in areas such as crop science, water and sanitation, and communicable disease.

In Cameroon, the Performance Based Financing (PBF) pilot covers public and private facilities in 26 districts and a population of 2.6 million. Operational data indicates that utilization of key services has increased substantially between 2013 and 2015 - institutional deliveries by 28 percent, family planning by 65 percent and immunization by 35 percent. More importantly quality of care as measured by the total quality of care score increased from 55 percent to 68 percent between 2013 and 2015.

In Nigeria, the PBF pilot, in the three states of Adamawa, Nasarawa and Ondo covers 900 facilities and a population of about 14million population. Early results show that the uptake of services has been very encouraging with the utilization of core maternal and child health services like immunization, deliveries in facilities and family planning showing significant improvements. Immunization coverage in pre-pilot facilities increased 5 percent to 44 percent. At the State level immunization coverage increased from 31 to 51 percent in Adamawa; 29 to 52 percent in Nasarawa and 42 to 48 percent in Ondo.

In Burundi, a country with a nationwide RBF program the average total quality score in health centers increased significantly from a baseline value of 34.6 to 80.5. Similar trends have also been observed in all 17 provinces of Burundi and variation between provinces has also reduced. The difference between most and least performing provinces reduced from 41.2 to 18.6 indicating geographical equity has also been improved for the quality dimension.

The Zambia RBF program, launched in 2012, contracts-in different structures in the public health system, and uses a fee-for-service approach to pay facilities in 11 districts based on the quantity of nine maternal and child health services delivered. Preliminary results from the impact evaluation indicate that RBF significantly increased utilization of MCH services and early health seeking behavior when the RBF districts are compared to the districts operating as “business as usual”. Women from health facilities in the RBF districts sought antenatal care about three weeks earlier than women receiving care in non-RBF districts.

2 As of March 11, 2015, the security situation in Yemen deteriorated to the degree that the World Bank could no longer exercise fiduciary or management oversight, and disbursement has been suspended on all Bank-funded projects. While the suspension remains, where possible and under emergency procedures, arrangements have been made with development partners to resume funding to key projects.